Journal ArticleDOI
Association of polypharmacy with nutritional status, functional ability and cognitive capacity over a three-year period in an elderly population.
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TLDR
To determine the association of polypharmacy with nutritional status, functional ability and cognitive capacity among elderly persons, a large number of elderly persons are surveyed.Abstract:
Purpose
To determine the association of polypharmacy with nutritional status, functional ability and cognitive capacity among elderly persons.
Methods
This was a prospective cohort study of 294 survivors from the population-based Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) Study, with yearly follow-ups during 2004 to 2007. Participants were the citizens of Kuopio, Finland, aged 75 years and older at baseline. Polypharmacy status was categorized as non-polypharmacy (0–5 drugs), polypharmacy (6–9 drugs) and excessive polypharmacy (10+ drugs). A linear mixed model approach was used for analysis the impact of polypharmacy on short form of mini nutritional assessment (MNA-SF), instrumental activities of daily living (IADL) and mini-mental status examination (MMSE) scores.
Results
Excessive polypharmacy was associated with declined nutritional status (p = 0.001), functional ability (p < 0.001) and cognitive capacity (p < 0.001) when compared to non-polypharmacy group. Age, institutional living, poor self-reported health and time of measuring were also associated with the three outcome measures. In the excessive polypharmacy group, the proportion of malnourished or at risk of it increased from 31% to 50%, having difficulties in daily tasks from 48% to 74% and impaired cognition from 36% to 54% during the follow-up. The mixed model analysis revealed that polypharmacy status was not able to predict the progress of MNA-SF, IADL and MMSE scores over a three-year time.
Conclusions
Excessive polypharmacy is associated with decline in nutritional status, functional ability and cognitive capacity in elderly persons. However, the changes in nutrition, physical functionality and cognition over a three-year period cannot be predicted by polypharmacy status. Copyright © 2011 John Wiley & Sons, Ltd.read more
Citations
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Journal ArticleDOI
Clinical consequences of polypharmacy in elderly
TL;DR: It is shown that well-designed interprofessional intervention studies that focus on enrolling high-risk older patients with polypharmacy have shown that they can be effective in reducing aspects of unnecessary prescribing with mixed results on distal health outcomes.
Journal ArticleDOI
Polypharmacy cutoff and outcomes: five or more medicines were used to identify community-dwelling older men at risk of different adverse outcomes.
Danijela Gnjidic,Sarah N. Hilmer,Sarah N. Hilmer,Fiona M. Blyth,Fiona M. Blyth,Vasi Naganathan,Vasi Naganathan,Louise M. Waite,Louise M. Waite,Markus J. Seibel,Markus J. Seibel,Andrew J. McLachlan,Andrew J. McLachlan,Robert G. Cumming,Robert G. Cumming,David J. Handelsman,David J. Handelsman,David G. Le Couteur,David G. Le Couteur +18 more
TL;DR: The study supports the use of five or more medications in the current definition of polypharmacy to estimate the medication-related adverse effects for frailty, disability, mortality, and falls.
Journal ArticleDOI
Health Outcomes Associated with Polypharmacy in Community-Dwelling Older Adults: A Systematic Review
Terri R. Fried,Terri R. Fried,John R. O'Leary,Virginia Towle,Mary K. Goldstein,Mary K. Goldstein,Mark Trentalange,Deanna K. Martin +7 more
TL;DR: Evidence regarding the health outcomes associated with polypharmacy, defined as number of prescribed medications, in older community‐dwelling persons, is summarized.
Journal ArticleDOI
Polypharmacy Among Adults Aged 65 Years and Older in the United States: 1988–2010
TL;DR: Higher medication use was associated with higher prevalence of functional limitation, activities of daily living limitation, and confusion/memory problems in 2009-2010, although these associations did not remain after adjustment for covariates.
Journal ArticleDOI
Risk Factors for Malnutrition in Older Adults: A Systematic Review of the Literature Based on Longitudinal Data
Nádia Cristina Fávaro-Moreira,Stefanie Krausch-Hofmann,Christophe Matthys,Carine Vereecken,Erika Vanhauwaert,Anja Declercq,Geertruida E Bekkering,Joke Duyck +7 more
TL;DR: These risk factors for malnutrition in older adults may be considered by health care professionals when developing new integrated assessment instruments to identify older adults' risk of malnutrition and to support the development of preventive and treatment strategies.
References
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Journal ArticleDOI
“Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician
Marshal F. Folstein,Marshal F. Folstein,Susan E B Folstein,Susan E B Folstein,Paul R. McHugh,Paul R. McHugh +5 more
TL;DR: A simplified, scored form of the cognitive mental status examination, the “Mini-Mental State” (MMS) which includes eleven questions, requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
A practical method for grading the cognitive state of patients for the clinician
TL;DR: The Mini-Mental State (MMS) as mentioned in this paper is a simplified version of the standard WAIS with eleven questions and requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
Journal ArticleDOI
Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living
M. P. Lawton,Elmne M. Brody +1 more
TL;DR: Two scales first standardized on their own population are presented, one of which taps a level of functioning heretofore inadequately represented in attempts to assess everyday functional competence, and the other taps a schema of competence into which these behaviors fit.
Journal ArticleDOI
Assessment of older people: self-maintaining and instrumental activities of daily living
M. P. Lawton,Elmne M. Brody +1 more
TL;DR: Two scales first standardized on their own population are presented, one of which taps a level of functioning heretofore inadequately represented in attempts to assess everyday functional competence, and the other taps a schema of competence into which these behaviors fit.
Journal ArticleDOI
Screening for Undernutrition in Geriatric Practice Developing the Short-Form Mini-Nutritional Assessment (MNA-SF)
TL;DR: The Mini-Nutritional Assessment can identify persons with undernutrition and can be used in a two-step screening process in which persons, identified as "at risk" on the MNA-SF, would receive additional assessment to confirm the diagnosis and plan interventions.